Undercover Probe Finds Health Law Failings

WASHINGTON (AP) — Congressional investigators using fake identities were able to obtain taxpayer-subsidized health insurance under President Barack Obama’s law, according to testimony to be delivered Wednesday.

The nonpartisan Government Accountability Office says its undercover investigators were able to get subsidized health care under fake names in 11 out of 18 attempts. The GAO is still paying premiums for the policies, even as the Obama administration attempts to verify phony documentation.

The agency’s findings are contained in testimony to be delivered at a House Ways and Means Committee hearing Wednesday. An advance copy was provided to The Associated Press.

Seto Bagdoyan, head of GAO audits and investigations, will also testify that there’s still a huge backlog of applications with data discrepancies, even though the administration has resolved some 600,000 cases.

The GAO tests revealed potential weaknesses in the nation’s newest social program. However, in the real world, it may be difficult for fraudsters to profit, since government subsidies are paid directly to insurance companies.

Still, Ways and Means Chairman Dave Camp, a Michigan Republican, said the health law is rife with “incompetence, waste and the potential for fraud.”

House Republicans have voted some 50 times to repeal or scale back Obama’s top domestic accomplishment, the sweeping health care overhaul that is currently providing coverage to an estimated 15 million people, through a combination of subsidized private insurance and expanded Medicaid.

The Obama administration says six of the GAO’s fake online applications were blocked by eligibility checks built into computer systems at HealthCare.gov. But the GAO says its undercover agents found a way around that, and were able to enroll anyway.

“We are examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes,” administration spokesman Aaron Albright said. At least on paper, fraudsters risk prosecution and heavy fines.

GAO said its investigators concocted fake identities using invalid Social Security numbers and falsely claiming citizenship or legal residence. In other cases, they made up income figures that would disqualify them from getting subsidies.

Among the findings:

-Contractors processing applications for the government told the GAO that their role was not to ferret out potential fraud.

-Five of six bogus phone applications went through successfully. The one exception involved an applicant who refused to provide a Social Security number.

-Six online applications were snagged by an identity checking system. But investigators just dialed a call center and all six were approved. That seemed to be an open pathway to coverage.

-The GAO also tried to check the reliability of counselors providing in-person assistance. In five out of six cases, investigators were unable to get help. In the final case, the counselor correctly told the undercover investigator that their stated income would not entitle them to subsidized coverage.